Alcohol Advertising: What Are the Effects?

Chapter 7: Prevention

Alcohol Advertising: What Are the Effects?

Does alcohol advertising increase the overall level of alcohol consumption? Does it predispose children and adolescents to drinking? Although these and other related questions have been raised by public health advocates and echoed in public opinion surveys, the evidence from research to date is mixed and far from conclusive. In general, studies based on economic analyses suggest that advertising does not increase overall consumption, but instead may encourage people to switch beverage brands or types. At the same time, research based on survey data indicates that children who like alcohol advertisements intend to drink more frequently as adults. While these findings might offer some grounds for both reassurance and concern, the limitations of the research methods that have been used hinder the ability to draw firm conclusions about cause and effect in either case.

In recent years, public health advocates have called for strict regulation or elimination of alcohol advertising (Mosher 1994), and communitylevel action has focused on reducing local alcohol advertising (Woodruff 1996). Particular attention has been devoted to how alcohol advertising might affect young people (Atkin 1993) and to the targeting of minority communities (Abramson 1992; Alaniz and Wilkes 1995; Scott et al. 1992). A poll of public attitudes found that 57 percent of the public support prohibiting alcoholic beverage advertisements on television, 64 percent support advertising to counteract alcohol advertisements, and 41 percent support prohibiting sports sponsorship by the alcohol industry (Kaskutas 1993).

As described in this section, researchers have examined the effects of alcohol advertising through four main types of studies: experimental research in controlled settings; econometric analyses, which apply economic research techniques; surveys; and intervention studies of

"media literacy" programs that encourage skepticism about advertisements. In general, experimental studies based in laboratory settings provide little consistent evidence that alcohol advertising influences people's drinking behaviors or beliefs about alcohol and its effects (Kohn and Smart 1984; Kohn et al. 1984; Lipsitz 1993; Slater et al. 1997; Sobell et al. 1986). In addition, econometric studies of market data have produced mixed results, with most showing no significant relationship between advertising and overall consumption levels (Fisher and Cook 1995; Gius 1996; Goel and Morey 1995; Nelson and Moran 1995).

Survey research of children and adolescents, however, provides some evidence of links between alcohol advertising and greater intentions to drink, favorable beliefs about alcohol, and a greater likelihood of drinking (Austin and Meili 1994; Austin and Nach-Ferguson 1995; Grube 1995; Grube and Wallack 1994; Wyllie et al. 1998a,b). Still, the survey study designs employed thus far have not been able to establish whether, for example, the advertisements caused the beliefs and behaviors, or whether preexisting beliefs and behaviors led to an increased awareness of the advertisements. Media literacy training may increase the ability of children and adolescents to offer counterarguments to messages in alcohol advertisements (Austin and Johnson 1997a,b; Slater et al. 1996a), but studies have not yet measured whether these effects persist beyond a short term.

The following is a review of the evidence, from each of these research areas, about the effects of alcohol advertising on alcohol consumption, alcohol-related problems, and drinking-related beliefs and attitudes. Studies have been drawn from such diverse fields as drug and alcohol studies, communications, psychology, sociology, marketing and advertising, and economics.

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Background: The Frequency and Content of Advertising Messages

Concerns about alcohol advertising stem at least in part from its pervasiveness. The alcohol industry spent $1.03 billion on alcohol advertising in 1996, with the expenditures concentrated on television commercials and beer advertising (Besen 1997). Thus alcohol advertising, especially for beer, appears relatively frequently on television. Moreover, this advertising tends to appear most often during sports programming. While about one alcohol commercial appears in every 4 hours of prime-time fictional programming, one appears for every 25 minutes of programming for major professional sports (football, baseball, and basketball) and one for every 50 minutes of college sports programming (Grube 1993, 1995; Madden and Grube 1994). Overall, alcohol commercials make up 1.5 percent of all advertisements on prime-time television and 7.0 percent of all advertisements in sports programming.

Standard commercials, however, are not the only way in which alcohol is marketed on television. Alcohol advertisers use other types of promotions embedded in sports programming to place their product names, slogans, and symbols before the television viewing audience. Stadium signs, brief sponsorships (such as "This half-time report is brought to you by..."), and on-site promotions (such as product symbols and names on race cars) are broadcast to the television viewing audience at a rate of 3.3 per hour in major professional sports programming, 3.0 per hour in other professional sports programming, and 0.3 per hour in college sports programming (Grube 1993, 1995; Madden and Grube 1994).

The engaging images and messages in alcohol commercials may add to the perception, among critics, that advertisements contribute to increased drinking and drinking problems. What is engaging about the advertisements? Although no recent research has investigated this question, older content analysis studies of alcohol advertisements show that alcohol ads link drinking with highly valued personal attributes, such as sociability, elegance, and physical attractiveness, as well as

Alcohol Advertising: What Are the Effects?

with desirable outcomes, such as success, relaxation, romance, and adventure (see, for example, Atkin and Block 1980; Strickland et al. 1982).

Researchers have been particularly interested in the degree to which children and adolescents pay attention to these commercials. In one survey of fifth- and sixth-grade children, 59 percent of the children could correctly identify the brand of beer being promoted from an edited, still photograph taken from a television commercial featuring Spuds McKenzie (Grube 1995). A vast majority of the children (82 percent) in the same survey correctly matched the advertising slogan, "Spuds McKenzie, the original party animal," with Budweiser.

Alcohol advertising with celebrity endorsers, humor, animation, and rock music has been shown to be especially appealing to adolescents (Atkin and Block 1983; Grube 1995). In addition, a study of adolescent boys confirmed that they were particularly attracted to alcohol advertisements depicting sports (Slater et al. 1996c, 1997). In one recent study, adolescents perceived that a significant number of alcohol advertisements portray people under 21 years of age (Slater et al. 1996b). Other research has indicated, however, that adolescents' identification with the actors in the ads, or their desire to be like the actors, is relatively low (Austin and Meili 1994). Lifestyle- or image-oriented alcohol advertising has been shown to be more appealing to both adults and adolescents than is alcohol advertising that promotes only product quality (Covell et al. 1994).

Besides the frequency of advertisements and their appeal to minors, concerns have also stemmed from advertising content that raises safety questions. One study found that 33 percent of television beer advertisements (16 of 49) contained scenes of people drinking and either driving or engaging in water activities such as swimming or boating (Grube 1995). Moreover, messages to drink safely and moderately (such as "Know when to say when") appear in less than 1 percent of alcohol advertisements and have been criticized for not clearly defining responsible drinking (DeJong et al. 1992).

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Chapter 7: Prevention

Does Alcohol Advertising Affect Drinking or Drinking Problems?

Earlier reviews have concluded that the effects of alcohol advertising on people's drinking beliefs and behaviors are limited, at best (Atkin 1995; Calfee and Scheraga 1994; Fisher 1993; Smart 1988). More recent research has not markedly changed this conclusion.

The two key questions that frame most of the current studies are whether alcohol advertising (1) increases overall drinking and drinking problems in the population or (2) increases drinking among children and adolescents or favorably predisposes them toward alcohol. A third important question about the possible effects of alcohol advertising on minority populations, who have been targets of advertising for particular alcohol products, has received little or no quantitative research to date and therefore is not covered in this review.

In the descriptions below, alcohol advertising research is grouped into four types of studies: experimental studies, econometric studies, survey research, and media literacy interventions.

Experimental Studies

Experimental studies have investigated how short-term exposure to alcohol advertising affects people's drinking beliefs and behaviors under controlled conditions. Typically, a group of participants is exposed to one or more alcohol advertisements embedded in a television program, among a series of neutral advertisements, or, in the case of print advertising, in a booklet or magazine. The investigators then compare the experimental group's beliefs or behaviors related to drinking with those of a control group that views the same items without the embedded alcohol advertisements. The results of earlier experimental studies have been mixed, with some studies finding no effects (Kohn et al. 1984; Sobell et al. 1986) and others finding small or short-term effects for some study participants (Kohn and Smart 1984).

A later study applied this approach to examine the effects of television beer advertising on the

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drinking beliefs of young people who were not regular drinkers (Lipsitz et al. 1993). The researcher showed three groups of fifth- and eighth-grade students videotapes containing 40 television commercials. One group saw videotapes containing 5 beer commercials scattered among 35 other commercials. Another group saw videotapes with the same five beer commercials plus two antidrinking public service announcements (PSA's). The control group saw videotapes with five soft-drink commercials in place of the beer commercials. The remaining 35 commercials were the same for all groups and advertised a variety of products, such as foods and automobiles.

After viewing the videotapes, the children completed a memory task that showed they attended to the advertisements and remembered seeing the beer and soft-drink commercials. Then they completed an "alcohol expectancy" questionnaire that measured the extent to which they believed drinking would lead to a number of desirable outcomes, such as enhancing social behavior or promoting relaxation. Neither exposure to the beer advertisements nor to the antidrinking PSA's affected the children's expectancies about the outcomes of drinking.

More recently, an experimental study examined young people's responses to variations in the placement of alcohol advertisements. The researchers exposed a sample of 244 high school students to videotaped television beer advertisements embedded in either a sports program or an entertainment program (Slater et al. 1997). The researchers asked the students to complete a questionnaire that measured their reactions after viewing each advertisement. The research team also asked the students about their present alcohol use and their future drinking intentions.

The responses were split along gender lines. The female students responded more negatively to the beer advertisements and offered more counterarguments than did the male students, particularly when the programs they watched had sports content.

In addition, adolescents of Anglo-American descent who responded favorably toward the beer advertisements were more likely to report current drinking and future intentions to drink. This finding might be interpreted as suggesting that alcohol advertising increases drinking predisposition. The effects were relatively small, however, and the finding did not hold for Latino students. Moreover, the design of this study did not allow the researchers to determine whether a favorable orientation toward alcohol advertisements predisposed the young people to drinking, or whether being predisposed to drinking made the young people more favorable toward alcohol advertisements. Nevertheless, the Latino-Anglo difference is an interesting finding. Although the Latino students liked the advertisements, they may have seen them as less personally relevant. Factors such as identification or perceived similarity with actors in television advertisements may influence the relationship between a person's attitude toward alcohol advertisements and his or her beliefs and behaviors related to drinking.

Experimental Studies: Methodological Considerations. Overall, the results of these experimental studies offer only limited support, at best, for effects of alcohol advertising on drinking beliefs and intentions (Atkin 1995; Grube and Wallack 1994; Lastovicka 1995; Thorson 1995). Although laboratory experimental studies can control for extraneous factors and can allow for strong causal inferences, they often lack realism. In a typical study, respondents are exposed to alcohol advertising in an artificial setting such as a schoolroom. The stimulus advertisements are often embedded among a very large number of "neutral" advertisements shown one after another. This style of presentation does not reflect the natural situation in which viewers are usually exposed to advertising. As a result, it is difficult to draw conclusions about the "real world" effects of alcohol advertising on beliefs and behaviors on the basis of these laboratory studies.

Furthermore, advertisers target specific audiences with particular advertisements (Thorson 1995). If the stimulus advertisements do not contain

Alcohol Advertising: What Are the Effects?

images, themes, or music that appeal to the participants in a specific study, it is less likely that any effects will be observed. In most cases, including the study described previously involving third and fifth graders (Lipsitz et al. 1993), the stimulus advertisements are not described in enough detail to ascertain if they were appropriate for the experimental participants. Additionally, these laboratory experiments can only address the effects of short-term exposure to a limited number of alcohol advertisements. The relevance of such studies for understanding the cumulative effects of exposure to hundreds or thousands of alcohol advertisements over many years is questionable. This research paradigm may be most relevant to understanding which ads appeal to viewers and whether or not exposure to alcohol advertising elicits immediate and short-term increases in consumption among those already favorably predisposed to drinking (Kohn and Smart 1984).

Econometric Studies

A number of studies have applied the theoretical and statistical techniques of economic research to analyze issues relating to alcoholic beverage advertising. Generally these econometric studies have focused on the relationship between the advertising expenditures of the alcohol industry and the average amount of alcohol consumed per person (per capita consumption) or the amount of alcohol sales, with price and other factors taken into account. A few studies have investigated whether alcohol advertising affects rates of traffic fatalities and other alcohol-related problems such as liver cirrhosis.

Overall, the econometric studies conducted to date provide little consistent support for a relationship between alcohol advertising and alcohol consumption and related problems. They do provide indirect support, however, for the hypothesis that alcohol advertising leads to changes in brand or beverage preferences without increasing total consumption. To follow is a summary of recent studies as well as criticisms related to methodological issues.

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Chapter 7: Prevention

The Question of Consumption. The overall conclusion from econometric studies conducted prior to 1990 is that alcohol advertising exerts a negligible effect on overall alcohol consumption (for reviews, see Calfee and Scheraga 1994; Fisher 1993; Saffer 1995a,b, 1996). These early studies suggest that a 1-percent decrease in alcohol advertising would be associated, at most, with a 0.1-percent decrease in consumption (Godfrey 1994).

Since then, two econometric studies have departed from the previous findings in that they reported substantive and statistically significant effects of alcohol advertising on alcohol-related problems (Saffer 1991, 1997). The first of these studies reported that countries with restrictions on broadcast alcohol advertisements had lower rates of both alcohol consumption and traffic fatalities (Saffer 1991, 1993b). Using data from 17 European and North American countries for the years 1970 through 1983, the researcher determined that countries with partial restrictions on television alcohol advertising, such as prohibitions on commercials for liquor, had 16-percent lower alcohol consumption rates and 10-percent lower motor vehicle fatality rates than did countries with no restrictions. In turn, countries with complete bans on television alcohol advertisements had 11-percent lower consumption rates and 23-percent lower motor vehicle fatalities rates than did countries with partial restrictions.

Controversy about these findings arose with the publication of a reanalysis (Young 1993) that criticized the original study (Saffer 1991) on a number of grounds. The reanalysis indicated that countries with low rates of alcohol problems were more likely to adopt bans on alcohol advertising because of preexisting, conservative drinking styles and attitudes. The reanalysis also suggested that partial alcohol advertising bans might actually increase alcohol consumption, a counterintuitive outcome. Questions about these findings, in turn, were raised by the author of the original study, who reported that the reanalysis suffered from methodological flaws that rendered the results inconsistent (Saffer 1993b).

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More recently, another study reported significant advertising effects on drinking problems (Saffer 1997). The study has a number of methodological strengths and, although it cannot establish causation, it offers the strongest econometric evidence to date that alcohol advertising might influence drinking problems. The researcher looked at the relationship between motor vehicle fatalities and variations in local alcohol advertising in the top 75 media markets in the United States from 1986 through 1989. Alcohol advertising was represented as the sum of industry expenditures for producing and broadcasting television, radio, and outdoor advertisements, weighted for their relative impact based on the estimated number of people exposed to each.

After accounting for regional price differences and population variables such as income and religion, the researcher found that increases in alcohol advertising were significantly related to increases in total and nighttime vehicle fatalities. The effects appeared to be greater for older drivers than younger drivers (18 through 20 years old). On the basis of these analyses, the researcher estimated that a total ban on alcohol advertising might reduce motor vehicle fatalities by as much as 5,000 to 10,000 lives per year.

A separate analysis examined how variations in prices paid by the alcohol industry for advertising might influence rates of motor vehicle fatalities. The researcher found that higher advertising prices were associated with lower fatality rates, apparently because higher prices reduced the amount of advertising and consequently the rate of alcohol consumption. These results indicated that eliminating the advertising tax credit for the alcohol industry would reduce motor vehicle fatalities by as many as 1,300 lives per year (Saffer 1997).

The divergence of the findings of this study from some earlier econometric studies may, in part, be a result of improvements in methodology. Investigating local variations in advertising and adjusting for the relative impact of different media types are two important innovations that have not been duplicated in other econometric

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